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电子健康在慢性肾脏病中的生活方式干预:范围综述。

Lifestyle interventions delivered by eHealth in chronic kidney disease: A scoping review.

机构信息

Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, United Kingdom.

Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.

出版信息

PLoS One. 2024 Jan 24;19(1):e0297107. doi: 10.1371/journal.pone.0297107. eCollection 2024.

Abstract

A method of overcoming barriers associated with implementing lifestyle interventions in CKD may be through the use of eHealth technologies. The aim of this review was to provide an up-to-date overview of the literature on this topic. Four bibliographical databases, two trial registers, and one database for conference proceedings were searched from inception to August 2023. Studies were eligible if they reported a lifestyle intervention using eHealth technologies. A narrative synthesis of the findings from the included studies structured around the type of eHealth intervention was presented. Where a sufficient number of studies overlapped in terms of the type of intervention and outcome measure these were brought together in a direction of effect plot. There were 54 included articles, of which 23 were randomised controlled trials (RCTs). The main component of the intervention for the included studies was mobile applications (n = 23), with the majority being in the dialysis population (n = 22). The majority of eHealth interventions were reported to be feasible and acceptable to participants. However, there was limited evidence that they were efficacious in improving clinical outcomes with the exception of blood pressure, intradialytic weight gain, potassium, and sodium. Although eHealth interventions appear acceptable and feasible to participants, there is insufficient evidence to make recommendations for specific interventions to be implemented into clinical care. Properly powered RCTs which not only demonstrate efficacy, but also address barriers to implementation are needed to enhance widespread adoption.

摘要

克服与 CKD 生活方式干预实施相关障碍的一种方法可能是通过使用电子健康(eHealth)技术。本综述的目的是提供该主题最新文献综述。从建库到 2023 年 8 月,检索了四个文献数据库、两个试验登记处和一个会议论文数据库。如果研究报告使用电子健康技术实施生活方式干预,则符合入选标准。根据电子健康干预类型对纳入研究的结果进行了叙述性综合,提出了一种综述。如果有足够数量的研究在干预类型和结果测量方面重叠,则将其放在一个效应方向图中。共纳入 54 篇文章,其中 23 篇为随机对照试验(RCT)。纳入研究干预的主要组成部分是移动应用程序(n = 23),其中大多数是在透析人群中(n = 22)。大多数电子健康干预措施被报道是可行且可被参与者接受的。然而,除了血压、透析内体重增加、钾和钠之外,几乎没有证据表明它们在改善临床结局方面有效。尽管电子健康干预措施似乎对参与者是可接受和可行的,但没有足够的证据推荐将特定干预措施应用于临床护理。需要进行适当的、有力的 RCT 研究,不仅要证明疗效,还要解决实施障碍,以促进广泛采用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb7c/10807786/f58a4d8e924b/pone.0297107.g001.jpg

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